Training: Day 2

Another day of training today brought some medical oddities. Medicine is never boring! Here are some interesting things we saw today. As a fair warning, the following post contains pictures of blood and tissues. If you have a weak stomach, maybe you should consider just skipping this post. It is super fascinating though! 

Below: a shot I took while walking around the clinic. The people here are very self-sustaining. To the left you can see corn growing. They grow a lot of their own food, build their own houses, it's a very different style of living than what I am used to. It's enlightening to see what these people can do with the little they have.

At the clinic, the dogs are all enjoying the shade.

One of the females we spayed on a previous day. You can see the incision is healing quite nicely. There is still a bit of a knot and that may never fully resolve. Right now most of the bump is due to inflammation. Even once the inflammation goes down, the muscles we cut through will heal with scar tissue that may cause a small bump to remain.

We discovered a really cool medical oddity today. Dr. Bikash was performing what was believed to be a routine spay and having trouble locating the right ovary and uterus. Dr. Prabin stepped in to assist and found a large mass. At the time, he suspected an ovarian tumor or cyst. The incision was widened, multiple times unfortunately. (We try to keep the incisions as small as possible to reduce pain and healing time, but in this case, we couldn't get the mass out of the small incision that was initially made.) Eventually, he pulled this out. What...? That doesn't look like a cyst, but it doesn't quite look like a tumor either...turns out it was the remains of a fetus. The fetus has died a while ago and started to decompose within the uterus. In total, this dog had 5 mummified fetuses within her uterus. Here Dr. Prabin is holding one of the fetuses in his hand while trying to extract the next one.

I have never seen this before and I have observed hundreds of spays. This is a rare occurrence. We do not know the cause of the fetal deaths, because up until today we have never even seen this dog before. I talked over the case with Dr. Prabin and he speculates that the litter was full-term and the dog went into labor, everything normal up until this point. However, it was a difficult birth and a puppy became stuck in the cervix. This puppy prevented the birth of the remaining fetuses and they all eventually died. The dog's uterus then contracted down and the fetuses degraded, resulting in what you see above. Dr. Prabin said that we found this dog at the right time because if her uterus was not removed, it is likely the fetal bones would perforate her uterus and could puncture her intestines, causing a lethal infection. I am fascinated the dog survived this ordeal in the first place! Her spay was completed without further complications. Once the dog was stable and recovering, the doctors and I decided to get a closer look at the uterus and what remained of the puppies. 

As you can see, not much remained. The uterus was contracted down so tight on the fetuses that they were difficult to remove. Once we did get them out, it was basically bones wrapped in fur. Everything else had already been degraded.

Can you identify some of the bones? There are lots of ribs, little leg bones, and skull fragments in this picture. (Skull fragments because the skull bones do not fuse until a few months after birth.)

I have not followed up on this case, but I would expect that she remained at the clinic under observation for a few more days before being released back to the area she was picked up from. Medicine is never boring. I love it!